Alan Warsap was our medical officer but I am sad to say I have no memories of him. As I wasn't wounded I had no contact with the regimental medical team except for the crash course in battlefield casualty handling that we all got. I do of course remember many of the events he talks about such as staying in the sheep pens immediately after the battle and the time at Ajax Bay where we had time to wind down.
On reflection I think he is right in saying that the Battalion gained a lot from this and certainly I felt at home with the Scots Guards. I had a very hard time 1 year later when I was posted to 1QOH in Ireland as I lost access to to the one group of people who I felt I could relate too.
What I didn't realise is that so many Scots Guards left and that most had no contact with the regiment for decades after like myself. Of all the veterans that I met last year only Alex Allender seemed untouched by the events. I guess a combionation of a long career in the Army and the fact he was in his 30's at the time meant he has been able to adjust and obsorb the memories. For most of us who experienced it at a younger age and then subsequently left the Army and then lost the implicit support offered by being with like people the Falklands has been harder to life with.
Anyway here is what Alan had to say...
It is close to twenty-five years since the Falkiands-Malvinas War. My personal, retrospective observations are made not only from the events of 1982, but are influenced by fifty years of involvement with the British Army from 1954 until 2004. This contact has included time as an Army General Practicioner, Regimental Medical Officer (RMO) and, lastly, as the President of an Army Medical Board responsible for examining, grading and sometimes medically discharging many men and women from service. An increasing number of boards involve at least some element of mental ill-health, mainly in men who had served in Bosnia and the Gulf War. Even today, working for The Tribunals Service, I still have contact with the medical and social problems of ex-servicemen.
As for the 2nd Battalion, Scots Guards’ medical arrangements and training, I acknowledge the full support received from my Commanding Officer, the then Lieutenant-Colonel Mike Scott, my Medical Senior NonCommissioned Officer, Colour-Sergeant Baird and our Padre, the Reverend Angus Smith. At the time of the Falklands I was, in addition to being the Battalion’s RMO, on the staff of the Royal Army Medical College. The Professor of Military Psychiatry at the College was the then Colonel Peter Abraham. He guided me as to what might be possible with regard to the recognition and management of immediate battle shock casualties. This information I shared with my CO and, having just been warned for Falklands duty, it focussed our minds.
On Tumbledown during the night and morning of 13-14 June 1982, eight Scots Guardsmen and a Royal Engineer were killed or reported missing and forty wounded. Psychological casualties at that stage were virtually invisible, or at least battle-shock had not led to defeat. I recall only three possible battle-shock casualties at this early stage, one not of our unit, and one who recovered so quickly that he was an efficient soldier for the rest of the battle and afterwards. The third cannot be discussed — even now. He did not engage with any part of our unit medical team, but may well have been such a casualty. After post-tour leave I recall one Junior NCO who exhibited classical symptoms of post battle stress adjustment reaction. He declined psychiatric referral — I hope he did well.
Recently I was encouraged to hear from retired Commodore Toby Elliott from the Ex-Servicemen’s Mental Health Society and “Combat Stress” organisation that of the eight hundred servicemen from the Falklands conflict known to him, only four were ex-Scots Guardsmen. However I am now aware that everyone, including myself, probably sustained a highly variable permanent mental scarring. In many this is dormant, but can be activated by life events in the future. What hides this scar is the great variability of individuals to cope with the mental damage sustained. The natural tendency in many to deny or unconsciously suppress the psychological effects of battle trauma is what medical and command authority is unwittingly endorsing (and I understand this). As a result stoicism is mistaken for absence of mental scarring and only manifest psychiatric illness acknowledged. Variability in individual soldiers’ reactions to the same battle trauma is mistakenly seized on to deny that mental scarring has occurred. For example, a heavy mortar round bursts near to and equidistant from two soldiers. One with poor resilience has a life dogged by intermittent mental ill health and dependency, often with a war disability pension to help support him. His comrade may appear at first successfully to have avoided mental scarring only to suffer partially hidden handicaps of suppressed symptoms which may or may not break through into mental ill health later in life. Variability is such that it is not unknown to me that some soldiers claim traumatic events in their careers that they have not witnessed themselves but heard about from comrades. They cannot identify what makes them now feel different but feel altered by their experiences compared to the person they used to be.
I emphasise the great importance attached to the psychotherapeutic benefit gained by everyone in the Battalion from the opportunity to “wind-down” collectively after the battle as the unit rested up in the sheep sheds at Fitzroy. Here, all ranks were jammed together out of the wind for about three days. We then spent long weeks, less closely confined, but still very much together in sub-units on a ship, and then on garrison duty on West Falkland at Port Howard. We travelled back to UK, still all together, by ship to Ascension Island, and then flew back to post-tour leave.
The dominating medical condition we had to deal with after 13-14 June was, for many, the pain and disability of trench foot. All through that time until we returned from leave “sick parade” numbers were very low indeed, apart from the trench foot. There were no psychological casualties at this time — that is, none were evident. Late on 14 June, after the ceasefire, our Regimental Aid Post (RAP) treated some dozen Argentinian soldiers for minor injuries on their way back to a holding facility in Stanley. I saw many acts of spontaneous kindness shown to them by our Guardsmen.
From the RAP on Goat Ridge on the morning of 14 June, during hostilities, elements of the RAP staff and I went forward in a Navy Sea King helicopter to start the casualty pick-up. As we took off we crossed the Gurkha mortar line which was close by and preparing to fire on a forward target, probably Mount William. The mortars erupted, and at least one mortar bomb must have passed through the helicopter’s rotor blade motion. We picked up, I believe, seven or eight Gurkha casualties. All were semi-comatose, sleep deprivation combining with the pain of their wounds. They were typically stoical, and we took them to the 16 Field Ambulance Advanced Dressing Station at Fitzroy. At this point helicopter evacuation formally ceased. Friendly-fire incidents, inevitable in war, take their own special toll — and we had been lucky to escape such a fate on this occasion.
Medical first-aid training for everyone, bolted on to all the preoperational work-up training, was most important. It was realistic and often confrontational, including the practising of burials and watching uncut films of casualties from the Vietnam War. This latter was the idea of the then Captain Tim Spicer, our Operations and Training Officer. With this the men were made first-aid reliant in pairs and small groups. However, it is important to de-select for combat any soldier with unresolved mental health or drugs problems, and also only fair to inform recruits about the full military significance for them of voluntary service in the Army.
Casualty evacuation plans must be very flexible and always a primary command responsibility. Delayed evacuation was inevitable, depending as it did on scarce helicopter availability. Here, the sustaining treatment given by the Pipes and Drums Platoon first-aid trainers was of key importance, embedded as they were in all subunits. The extent of long term mental scarring and acute shell-shock, that is, battle-immediate casualties, is directly related to the number of physical casualties and the intensity and character of the conflict.
Following the initial shock-effects of battle from fear, fatigue, explosions and sights, there follows a degree of ‘post-battle adjustment reaction’ for weeks and months afterwards, characterised by over- arousal feelings, family and social maladjustment, anger and aggressiveness. Our CO warned the Battalion about such difficulties before we all dispersed on leave. It helped us recognise such reactions as almost normal, and to be expected, when irrational anger welled up in the post-battle months. “If you feel angry you have nothing to prove,” I remember the CO saying. After battle and trauma you cannot help but experience irrational extreme irritation to the point of violence with the seemingly trivial concerns of those at home in the United Kingdom.
I now know, years later, that there is further, hitherto hidden mental damage for some to live with when post-battle mental damage leads to a tendency to develop ordinary mental illness in those vulnerable: I mean depression, suicide and even violent and criminal behaviour. Other burdens include alcoholism, drug misuse, family breakdown, nightmares, flashbacks, unemployment and destitution in extreme cases. Long-term, past exposure to battle seems to facilitate the early development of mental ill-health which might, anyway, have surfaced in the fullness of time in some subjects.
I recommend that the way to reduce battle stress in all its forms, short- and long-term, is to be found in the example of 2nd Battalion, Scots Guards: that is, allowing for a wind-down period to be made possible after high intensity warfare, perhaps along the formula of three days’ whole unit close-proximity living, resting, hearing how others got on, how they feel and their worries, talking through guilt and blame together, self-directed and in no way structured. This should be followed by three weeks’ less intensive interaction and debriefing. It would be helpful at this time for officers to brief the whole unit on how the operation or battle worked out (or otherwise) overall. Let everyone view the big picture so that the individual can understand how his contribution fitted in. At the same time, reassure the men that their contribution did help their fellow soldiers.
There should then be a total period of three months away from the end of hostilities, to include post-tour leave, in which soldiers should be relieved of any serious military responsibility and activity. There should be no enforced or organised counselling for all — especially not by non- unit personnel. In any large body of men, closely confined, there are always enough talkers and listeners to guarantee lively discussion and thought.
So, long-term, what should be done? Of course, emerging mental ill- health should come under the care of military or veterans’ mental health teams with welfare back-up. For those whose lives are faltering as the result of their mental scarring, value is likely to be had, not from opening the mental wounds of past traumas, but by helping those affected to climb a tower, as it were, above their troubles and be motivated to look out toward a series of personal goals, aiming to relaunch them into stable life.
This type of therapy was first proposed, or something much like it, by Captain Arthur Brock of the Royal Army Medical Corps. He was a psychiatrist in the Great War at Craiglockhart, wartime military hospital for officers in Edinburgh. Apparently the building still exists. It had been a Spa Hotel and is now student accommodation. Here were treated officers, most from the Somme era, who were suffering from battle neurasthenia or shell-shock, which was the terminology of the time. This is a key part of the history of battle-induced mental ill-health, and famous among its patients were Wilfred Owen and Siegfried Sassoon, the Great War Poets. As patients they were visited by Robert Graves, the poet and author, who also had post-war neurasthenia. He finally attempted to put his past on record and behind him when, ten years after the war, he wrote his autobiography, Goodbye to All That, and headed for a new life abroad.
One way to help deal with post-battle mental adjustment once and for all is to write down one’s experiences, good and bad, and one’s reactions, whether in the form of a notebook, tape or book, and, as it were, lock it away in the past before moving on.
As you get older the past has a curious quality of becoming closer to your own life. I can well remember London match-sellers on street corners, often with a crutch and Great War medals; being told that a neighbour had “shell-shock”; being taught to fish by a man who had been gassed on the Western Front. At a recent Parochial Church Council meeting, of the eleven souls present, two had had fathers who survived the Battle of the Somme. With such reminders is it not reasonable in our more psychologically vulnerable age to make long-term military mental health and support provision for those affected by combat?
Practical help must include money. The current compensation for losing a finger in battle is £2,559 (single payment). Soldiers should not receive lump sum payments. They will need the money later in their lives and long-term, regardless, and rightly so, of whether the victim shows his hand proudly to his grandchildren or to the examiner for incapacity benefits. We all cope differently. There is no logic in giving compensation for a little finger and not for mental scarring. The scar must be compensated for, not allowed to develop into some long-term mental illness which the scarring may predispose the soldier to. How do we do this? A war pension based on the number of days in combat and intensity of that combat as judged from measures such as physical casualty rates, death rates, ammunition expenditure, etc? In this way, retrospectively, scores are produced for each day, the worst possible day being 100 points, e.g. the first day on the Somme (but no day will ever equal that). An agreed formula calculation could be arrived at so as to produce a modest pension increment to retirement pay for those exposed to agreed significant battle-trauma.
Practical help might also include regular, if brief, long-term follow-up of those becoming the mental health casualties of battle or those with high “Somme” scores, e.g. by Internet or text, and organised by the Veterans Welfare Organisation with Regimental and British Legion input. This idea was, in part, promoted by a conversation I had with Lieutenant Robert Lawrence, who was very badly wounded in the Tumbledown attack. Robert went furthest forward of any officer before he fell. I know also now that his Company, led by Major Simon Price, carried out an exemplary night attack in mountainous terrain, the worth of which I only recently came to appreciate.
Recently I have had a glimpse of medical advances which indicate a possibly more sound method of diagnosing and treating different types of mental health illness with the help of brain-scanning and imaging. There is hope here for the future casualty. However, I have two postscripts.
What is the Tumbledown legacy of the 2nd Battalion, Scots Guards? It is the intense low murmuring roar that was so distinctive and memorable as the Battalion wound-down during the time in the Fitzroy sheep sheds, exchanging their experiences, worries and fears. I shall never forget it and neither should the Army Medical Services. This points the way to bring practical clarity of action to the part-prevention and long-term military medical care and support for those damaged by war.
Finally, about five years after the war I was doing a short locum duty with the United Nations Forces in Cyprus (UNFICYP). Along the camp road I encountered the first Argentinian serviceman I had seen since the war. His unit was newly arrived in Cyprus. I was unsure of his rank and no doubt he felt the same. Each off us saluted early, only to salute exactly together. We were very much on the same side. For me the war was over.